Jeanny Aragon-Ching, MD, FACP, of the Inova Schar Cancer Institute, Fairfax, VA, discusses the comparative analyses of trends and survival in patients with urothelial versus nonurothelial bladder carcinoma: National Cancer Database (NCDB) analysis, presented at the 2019 Genitourinary Cancers Symposium, held in San Francisco, CA.
Transcript (edited for clarity)
What we did was, we looked at the National Cancer Database, which is actually a database within the US that’s consistent of a lot of cancer centers that are part of the COC, the Commission of Cancer and endorsed by the American College of Surgeons. They have a de-identified data base that includes looking at urothelial patients and
Now, we know for bladder cancer that majority of patients will have urothelial, rather than non-urothelial subtypes. Non-urothelial subtypes of bladder cancer typically includes adenocarcinoma, squamous cell, sarcomatoid, or neuroendocrine features of bladder cancers. Those areas and those patients, unfortunately, are not well-represented in a lot of clinical trials.
What we tried to do was examine the trends and analysis for survival for all of these patients. What we found was urothelial cancers made up over 70,000 patients, and only about over 5,000 patients made up the non-urothelial cohort. Now, median age was probably equivalent between the two. There were a little bit more African Americans in the non-urothelial cohort. What we found too, was more patients with higher stages, stage 3 and 4, were found in the non-urothelial cohort. More importantly, the overall survival unfortunately, seems to be much worse for the non-urothelial compared to their urothelial cohort.
In summary, I think there’s still a lot of work to be done. These are just trends and analysis that we looked at. It certainly recapitulates what we see in practice, where a lot more patients have a urothelial carcinoma. A lot of the current therapies we have are geared towards more urothelial carcinomas than non-urothelial carcinomas. If we’re saying that their survival is worse, then more treatment options have to be investigated.